SUO 2013 – Session Highlights: Targeted magnetic resonance imaging/ultra…

http://www.urotoday.com/Prostate-Cancer/suo-2013-session-highlights-targeted-magnetic-resonance-imaging-ultrasound-fusion-biopsy-significantly-outperforms-random-12-core-biopsy-for-prediction-of-total-prostate-cancer-tumor-v.html

SUO 2013 – Session Highlights: Targeted magnetic resonance imaging/ultrasound fusion biopsy significantly outperforms random 12-core biopsy for prediction of total prostate cancer tumor volume

Published on 09 December 2013

BETHESDA, MD USA (UroToday.com) – Targeted magnetic resonance imaging/ultrasound (MRI/US) fusion biopsy has been shown to allow for more optimal lesion targeting. A group from NCI conducted this study to correlate the highest % core involvement and corresponding tumor length for both targeted fusion and random 12 core biopsy with total tumor volume.

The authors reviewed 696 men who underwent multiparametric MRI with targeted MRI/US fusion biopsy at NCI and then identified 109 men who met Johns Hopkins criteria for active surveillance. They calculated tumor volume in fusion biopsy-positive lesions and then correlated the highest % core involvement and corresponding tumor length for both targeted fusion and random 12-core biopsy. Using bivariate analysis they looked for the empirical relationship between these variables. For the highest percentage core involvement, targeted biopsy showed a positive correlation (R=0.57), whereas 12-core biopsy showed a poor correlation (R=0.016) with the total tumor volume (p < 0.0001 and p=0.91, respectively). Also, for tumor length of the highest % core, targeted biopsy showed a positive correlation (R=0.6), whereas 12-core biopsy showed a poor correlation (R=0.01) with the total tumor volume (p < 0.0001 and p=0.94, respectively).

The authors concluded that targeted biopsy better predicts overall burden of disease and can aid in risk stratification of patients seeking active surveillance.

Presented by:
Chinonyerem Okoro, Soroush Rais-Bahrami, Arvin George, Peter A. Pinto, et al.
National Cancer Institute

Reported by:
Reza Mehrazin, MD from the 14th Annual Meeting of the Society of Urologic Oncology (SUO) “Extraordinary Opportunities for Discovery” – December 4 – 6, 2013 – Bethesda, MD USA

Fox Chase Cancer Center, 333 Cottman Avenue, Philadelphia, PA USA

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Potential of PET/MRI for diagnosis of prostate cancer – Abstract

Published on 23 September 2013

CLINICAL/METHODICAL ISSUE: A present goal is to improve detection and staging of prostate cancer using innovative imaging technology such as PET/MRI.

STANDARD RADIOLOGICAL METHODS: The modality of choice for detection of prostate cancer is multiparametric MRI. Furthermore, PET/CT is used, in particular, for the detection and staging of distant metastases and recurrent disease. For assessment of bone metastases, the method most commonly used is bone scintigraphy.

METHODICAL INNOVATIONS: The development of a simultaneous hybrid PET/MRI system is the last great “fusion” of the known cross-sectional image modalities. In addition, synthesis of new, innovative tracers such as 18F-FACBC or 68Ga-PSMA allows more specific detection of prostate cancer.

PERFORMANCE: Hybrid PET/MRI imaging has the potential to replace conventional imaging techniques in the future.

ACHIEVEMENTS: The method is just starting the broad application. Clinical studies must be expanded in order to substantiate the additional value of the method.

PRACTICAL RECOMMENDATIONS: Currently, there is still a low distribution situation, since it is a new and cost-intensive method. At the same time, there is still no consistent solution for reimbursement. The importance in practice first rises by clarifying the payment situation and further demonstration of the method’s benefit by larger studies.

Written by:
Röthke MC, Afshar-Oromieh A, Schlemmer HP.   Are you the author?
Abteilung für onkologische Radiologie, Deutsches Krebsforschungszentrum (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Deutschland.m.roethke@dkfz.de

Reference: Radiologe. 2013 Aug;53(8):676-81.
doi: 10.1007/s00117-013-2499-0

 

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